Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study

Ole Köhler-Forsberg; Fenfen Ge; Arna Hauksdóttir; Edda Bjork Thordardottir; Kristjana Ásbjörnsdóttir; Harpa Rúnarsdóttir; Gunnar Tómasson; Jóhanna Jakobsdóttir; Berglind Guðmundsdóttir; Andri Steinþór Björnsson; Engilbert Sigurðsson; Thor Aspelund; Unnur A. Valdimarsdottir

doi:10.1192/bjp.2023.128

Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study

Ole Köhler-Forsberg^*, Fenfen Ge, Arna Hauksdóttir, Edda Bjork Thordardottir, Kristjana Ásbjörnsdóttir, Harpa Rúnarsdóttir, Gunnar Tómasson, Jóhanna Jakobsdóttir, Berglind Guðmundsdóttir, Andri Steinþór Björnsson, Engilbert Sigurðsson, Thor Aspelund, Unnur A. Valdimarsdottir

^*Corresponding author for this work

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3 Citations (Scopus)

Abstract

Background Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. Aims The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. Method Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. Results Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. Conclusion Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.

Original language	English
Journal	British Journal of Psychiatry
Volume	224
Issue	1
Pages (from-to)	6-12
Number of pages	7
ISSN	0007-1250
DOIs	https://doi.org/10.1192/bjp.2023.128
Publication status	Published - Jan 2024

Keywords

Adverse childhood experiences
bipolar disorder
childhood deprivation
schizophrenia
Anxiety/epidemiology
Humans
Risk Factors
Female
Adult
Adverse Childhood Experiences
Bipolar Disorder/epidemiology
Schizophrenia/epidemiology

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10.1192/bjp.2023.128Licence: CC BY

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Köhler-Forsberg, O., Ge, F., Hauksdóttir, A., Thordardottir, E. B., Ásbjörnsdóttir, K., Rúnarsdóttir, H., Tómasson, G., Jakobsdóttir, J., Guðmundsdóttir, B., Björnsson, A. S., Sigurðsson, E., Aspelund, T., & Valdimarsdottir, U. A. (2024). Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study. British Journal of Psychiatry, 224(1), 6-12. https://doi.org/10.1192/bjp.2023.128

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title = "Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study",

abstract = "Background Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. Aims The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. Method Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. Results Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. Conclusion Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.",

keywords = "Adverse childhood experiences, bipolar disorder, childhood deprivation, schizophrenia, Anxiety/epidemiology, Humans, Risk Factors, Female, Adult, Adverse Childhood Experiences, Bipolar Disorder/epidemiology, Schizophrenia/epidemiology",

author = "Ole K{\"o}hler-Forsberg and Fenfen Ge and Arna Hauksd{\'o}ttir and Thordardottir, {Edda Bjork} and Kristjana {\'A}sbj{\"o}rnsd{\'o}ttir and Harpa R{\'u}narsd{\'o}ttir and Gunnar T{\'o}masson and J{\'o}hanna Jakobsd{\'o}ttir and Berglind Gu{\dh}mundsd{\'o}ttir and Bj{\"o}rnsson, {Andri Stein{\th}{\'o}r} and Engilbert Sigur{\dh}sson and Thor Aspelund and Valdimarsdottir, {Unnur A.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.",

year = "2024",

month = jan,

doi = "10.1192/bjp.2023.128",

language = "English",

volume = "224",

pages = "6--12",

journal = "British Journal of Psychiatry",

issn = "0007-1250",

publisher = "Cambridge University Press",

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Köhler-Forsberg, O , Ge, F, Hauksdóttir, A, Thordardottir, EB, Ásbjörnsdóttir, K, Rúnarsdóttir, H, Tómasson, G, Jakobsdóttir, J, Guðmundsdóttir, B, Björnsson, AS, Sigurðsson, E, Aspelund, T & Valdimarsdottir, UA 2024, 'Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study', British Journal of Psychiatry, vol. 224, no. 1, pp. 6-12. https://doi.org/10.1192/bjp.2023.128

Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study. / Köhler-Forsberg, Ole ; Ge, Fenfen; Hauksdóttir, Arna et al.
In: British Journal of Psychiatry, Vol. 224, No. 1, 01.2024, p. 6-12.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder

T2 - population-based study

AU - Köhler-Forsberg, Ole

AU - Ge, Fenfen

AU - Hauksdóttir, Arna

AU - Thordardottir, Edda Bjork

AU - Ásbjörnsdóttir, Kristjana

AU - Rúnarsdóttir, Harpa

AU - Tómasson, Gunnar

AU - Jakobsdóttir, Jóhanna

AU - Guðmundsdóttir, Berglind

AU - Björnsson, Andri Steinþór

AU - Sigurðsson, Engilbert

AU - Aspelund, Thor

AU - Valdimarsdottir, Unnur A.

PY - 2024/1

Y1 - 2024/1

N2 - Background Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. Aims The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. Method Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. Results Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. Conclusion Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.

AB - Background Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. Aims The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. Method Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. Results Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. Conclusion Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.

KW - Adverse childhood experiences

KW - bipolar disorder

KW - childhood deprivation

KW - schizophrenia

KW - Anxiety/epidemiology

KW - Humans

KW - Risk Factors

KW - Female

KW - Adult

KW - Adverse Childhood Experiences

KW - Bipolar Disorder/epidemiology

KW - Schizophrenia/epidemiology

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U2 - 10.1192/bjp.2023.128

DO - 10.1192/bjp.2023.128

M3 - Journal article

C2 - 37850429

AN - SCOPUS:85175495314

SN - 0007-1250

VL - 224

SP - 6

EP - 12

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

IS - 1

ER -

Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study

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